To investigate the clinical characteristics and pathogenic bacteria distribution of patients with type 2 diabetes mellitus complicated with bloodstream infection, and to provide more effective and convenient treatment.

The clinical characteristics, pathogenic bacteria distribution and drug sensitivity of 92 patients with type 2 diabetes mellitus complicated with blood flow infection treated in the Sixth People’s Hospital of Zhangjiagang City from April 2014 to April 2018 were analyzed, retrospectively; while the risk factors influencing the prognosis of type 2 diabetes complicated with blood flow infection were analyzed by Cox regression.

The 92 patients with type 2 diabetes mellitus complicated with blood flow infection were mainly with body mass index (BMI) < 18.5 kg/m² (47/92, 51.09%), moderate and low fever (29/92, 72.82%), fever duration ≥ 7 d (62/92, 67.39%), course of disease ≥ 10 d (68/92, 73.91%), skin infection (50/92, 54.35%) and length hospitalization ≥ 15 d (53/92, 57.61%). The cure rate was only 84.78% (78/92). The results of blood culture showed that 23 cases (25.00%) were with Gram-positive bacteria infection, mainly Staphylococcus aureus (8/92, 8.70%) and coagulase-negative Staphylococcus (7/92, 7.61%); 69 cases (75.00%) were with Gram-negative bacteria infection, mainly Escherichia coli (32/92, 34.79%) and Klebsiella pneumoniae (14/92, 15.22%). The results of drug susceptibility test showed that Staphylococcus aureus sensitive drugs were mainly vancomycin, gentamicin and clindamycin, with the sensitivity of 100.00% (8/8), 75.00% (6/8) and 50.00% (4/8), respectively. Coagulase-negative Staphylococci sensitive drugs were mainly vancomycin and clindamycin, with the sensitivity of 100.00% (7/7) and 57.14% (4/7), respectively. Escherichia coli sensitive drugs were mainly piperacillin/tazobactam and aztreonam, with the sensitivity were 96.88% (31/32) and 90.63% (29/32), respectively. The sensitive drug of Klebsiella pneumoniae were piperazepine/zuobatan and ceftitam, with the sensitivity were 92.86% (13/14) and 85.72% (12/14), respectively. Cox regression univariate analysis showed that HbA1c (P < 0.001), BMI > 23.9 kg/m² (P = 0.03), high fever (P = 0.08), fever duration≥ 7 d (P = 0.09), course of disease ≥ 10 days (P = 0.09) and multiple organ failure (P < 0.001) were all risk factors affecting the prognosis (univariate inclusion criteria were P < 0.1). Cox regression multivariate analysis showed that HbA1c (P = 0.01) and multiple organ failure (P < 0.001) were both independent risk factors affecting the prognosis of type 2 diabetes mellitus complicated with bloodstream infection.

The main clinical features of type 2 diabetes mellitus complicated with bloodstream infection were poor blood sugar control, high BMI, persistent low and moderate fever, long course of disease, skin infection and long hospitalization. Most of the patients were with Gram-negative bacterial infection and serious drug resistance. Blood culture and drug sensitivity should be completed as soon as possible in order to guide rational drug use in clinic.